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Original Article |

Effects of Salivary Bypass Tubes on Fistula and Stricture Formation

Xerxes Punthakee, MD; Soroush Zaghi, MD; Vishad Nabili, MD; P. Daniel Knott, MD; Keith E. Blackwell, MD
JAMA Facial Plast Surg. 2013;15(3):219-225. doi:10.1001/jamafacial.2013.791.
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Importance Stricture and fistula formation are two of the most common long-term complications of free flap reconstruction of hypopharyngeal defects.

Objective To examine the effects of salivary bypass tubes (SBTs) on fistula and stricture formation after free flap reconstruction of hypopharyngeal defects.

Design Retrospective cohort study.

Setting Academic tertiary care medical center.

Participants A total of 103 consecutive patients who underwent hypopharyngeal free flap reconstruction.

Intervention Use of salivary bypass tube.

Main Outcome Measure Fistula and stricture formation.

Results The overall fistula and stricture rates were 14.6% and 27.2%, respectively. Subgroup analysis revealed fistula rates of 7.4% in patients who received SBTs and 22.4% in those who did not (P = .048). However, no statistically significant difference between the two groups was shown with multivariate analysis. The unadjusted stricture rate was 30.6% without vs 24.1% with SBT placement (P = .51).

Conclusions and Relevance Univariate analysis showed that SBT placement significantly reduced the risk of fistula in this population. Larger multicenter studies are needed to further explore the benefits of SBT use in preventing fistula and stricture formation.

Level of Evidence 3.

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